Coelho Silvia, Cabral Guadalupe, Lopes José A, Jacinto António
Intensive Care Department, Hospital Fernando Fonseca, EPE, Amadora, Portugal.
CEDOC - Chronic Diseases Research Center, NOVA Medical School, NOVA University of Lisbon, Lisbon, Portugal.
Nephrology (Carlton). 2018 Sep;23(9):805-814. doi: 10.1111/nep.13256.
Acute kidney injury is common and associated with negative renal and patient outcomes. The human kidney has a real but limited regeneration capacity. Understanding renal regeneration may allow us to manipulate this process and thus develop therapeutic weapons to improve patients' outcome. In the first part of this paper we discuss the clinical factors associated with renal recovery: baseline patient particularities, acute kidney injury characteristics and the medical approach taken in the short and long-term. In the second part, the cellular and molecular mechanisms underlying renal regeneration are explored. The immune system seems to have an important role, first promoting inflammation and then tissue healing. Other players, such as cellular senescence, mitochondrial dysfunction, renal haemodynamics and metabolic reprogramming also have a role in renal regeneration. We aim to develop a short review of renal regeneration, offering a holistic view of this process.
急性肾损伤很常见,且与不良的肾脏及患者预后相关。人类肾脏具有实际但有限的再生能力。了解肾脏再生可能使我们能够操控这一过程,从而开发出改善患者预后的治疗手段。在本文的第一部分,我们讨论与肾脏恢复相关的临床因素:患者基线特征、急性肾损伤特点以及短期和长期采取的医疗措施。在第二部分,我们将探讨肾脏再生的细胞和分子机制。免疫系统似乎发挥着重要作用,首先促进炎症反应,然后促进组织愈合。其他因素,如细胞衰老、线粒体功能障碍、肾脏血流动力学和代谢重编程在肾脏再生中也发挥作用。我们旨在对肾脏再生进行简要综述,全面呈现这一过程。